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Article ; Online: The dominant left ventricular assist device: lessons from an era.

Alam, Amit / Milligan, Gregory P / Gong, Timothy

2021 Volume 8, Issue 6, Page(s) 5551–5554

Abstract: The production and distribution of the HeartWare ventricular assist device has come to an abrupt end, but with this end comes the opportunity to reflect upon lessons learned from its lifespan. Running counter to the standard of evidence-based practice, ... ...

Abstract	The production and distribution of the HeartWare ventricular assist device has come to an abrupt end, but with this end comes the opportunity to reflect upon lessons learned from its lifespan. Running counter to the standard of evidence-based practice, the era of the HeartWare ventricular assist device was marred with fragmented data in relation to its primary counterpart, the HeartMate III. This created an incomplete understanding of devices, limited individualized patient care, and effectively positioned providers to make inferences regarding device superiority. We briefly review pertinent literature on this topic among the most commonly implanted durable devices from the era, detail the inherent limitations of this data, and argue the necessity of randomized clinical trials among novel devices towards the optimization of patient care.
MeSH term(s)	Heart Failure/surgery ; Heart-Assist Devices ; Humans
Language	English
Publishing date	2021-09-10
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2814355-3
ISSN	2055-5822 ; 2055-5822
ISSN (online)	2055-5822
ISSN	2055-5822
DOI	10.1002/ehf2.13565
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Reconsidering the Diagnostic Criteria of Right Ventricular Primary Graft Dysfunction.

Alam, Amit / Milligan, Gregory P / Joseph, Susan M

Journal of cardiac failure

2020 Volume 26, Issue 11, Page(s) 985–986

MeSH term(s)	Heart Failure ; Heart Ventricles/diagnostic imaging ; Humans ; Primary Graft Dysfunction ; Ventricular Dysfunction, Right/diagnostic imaging
Language	English
Publishing date	2020-08-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	1281194-4
ISSN	1532-8414 ; 1071-9164
ISSN (online)	1532-8414
ISSN	1071-9164
DOI	10.1016/j.cardfail.2020.08.001
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Zs.A 4340: Show issues

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Article ; Online: Recognizing Right Ventricular Dysfunction in Coronavirus Disease-2019-Related Respiratory Illness.

Milligan, Gregory P / Alam, Amit / Guerrero-Miranda, Cesar

Journal of cardiac failure

2020 Volume 26, Issue 6, Page(s) 476

MeSH term(s)	Betacoronavirus ; COVID-19 ; Coronavirus ; Coronavirus Infections ; Heart Failure ; Humans ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2 ; Troponin ; Ventricular Dysfunction, Right
Chemical Substances	Troponin
Keywords	covid19
Language	English
Publishing date	2020-05-11
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	1281194-4
ISSN	1532-8414 ; 1071-9164
ISSN (online)	1532-8414
ISSN	1071-9164
DOI	10.1016/j.cardfail.2020.05.003
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Article: Recognizing Right Ventricular Dysfunction in Coronavirus Disease-2019-Related Respiratory Illness

Milligan, Gregory P / Alam, Amit / Guerrero-Miranda, Cesar

J Card Fail

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #232530
Database	COVID19

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Article: Mitral stenosis produced by infective endocarditis involving a previously anatomically normal valve.

Roberts, Charles S / Milligan, Gregory P / Stoler, Robert C / Grayburn, Paul A / Roberts, William C

Proceedings (Baylor University. Medical Center)

2019 Volume 32, Issue 3, Page(s) 387–389

Abstract: Described herein is a 63-year-old man who developed methicillin- ... ...

Abstract	Described herein is a 63-year-old man who developed methicillin-sensitive
Language	English
Publishing date	2019-07-15
Publishing country	United States
Document type	Case Reports
ZDB-ID	2703932-8
ISSN	1525-3252 ; 0899-8280
ISSN (online)	1525-3252
ISSN	0899-8280
DOI	10.1080/08998280.2019.1617011
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Zs.A 6987: Show issues

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Article ; Online: Upper-extremity blood flow restriction: the proximal, distal, and contralateral effects-a randomized controlled trial.

Bowman, Eric N / Elshaar, Rami / Milligan, Heather / Jue, Gregory / Mohr, Karen / Brown, Patty / Watanabe, Drew M / Limpisvasti, Orr

Journal of shoulder and elbow surgery

2020 Volume 29, Issue 6, Page(s) 1267–1274

Abstract: ... the control group (P < .05). Arm and forearm circumferences significantly increased in the BFR limb compared ... with the non-BFR limb and control group (P = .01). The non-BFR extremity demonstrated greater grip strength ... than the control group (9%, P < .01). No adverse events were reported.: Conclusion: Low-weight BFR training provided ...

Abstract	Background: Blood flow restriction (BFR) training with low weight is purported to induce similar physiological changes to high-weight regimens with the benefit of less tissue stress. We hypothesized that low-weight training with BFR would produce increased gains in strength and hypertrophy for muscle groups proximal, distal, and contralateral to tourniquet placement compared with low-weight training alone. Methods: In this prospective, randomized controlled trial, healthy subjects were randomized into a 6-week low-weight training program either with or without BFR on 1 extremity. Outcome measures included limb circumference and strength. Comparisons were made between the BFR and non-BFR extremities, BFR and control groups, and non-BFR extremity and control groups. Results: A total of 24 subjects (14 BFR and 10 control subjects) completed the protocol. Significantly greater gains were observed in dynamometric strength both proximal (shoulder scaption [30% greater], flexion [23%], and abduction [22%]) and distal (grip strength [13%]) to the tourniquet in the BFR limb compared with both the non-BFR extremity and the control group (P < .05). Arm and forearm circumferences significantly increased in the BFR limb compared with the non-BFR limb and control group (P = .01). The non-BFR extremity demonstrated greater grip strength than the control group (9%, P < .01). No adverse events were reported. Conclusion: Low-weight BFR training provided a greater increase in strength and hypertrophy in the upper-extremity proximal and distal muscle groups compared with the control group. The non-BFR extremity showed a significant increase in grip strength compared with the control group, indicating a potential systemic effect.
MeSH term(s)	Adult ; Constriction ; Female ; Humans ; Hypertrophy ; Male ; Muscle Strength ; Prospective Studies ; Range of Motion, Articular ; Regional Blood Flow ; Resistance Training/methods ; Upper Extremity/blood supply ; Weight Lifting ; Young Adult
Language	English
Publishing date	2020-05-19
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	1170782-3
ISSN	1532-6500 ; 1058-2746
ISSN (online)	1532-6500
ISSN	1058-2746
DOI	10.1016/j.jse.2020.02.003
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Zs.A 3973: Show issues

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Article ; Online: Proximal, Distal, and Contralateral Effects of Blood Flow Restriction Training on the Lower Extremities: A Randomized Controlled Trial.

Bowman, Eric N / Elshaar, Rami / Milligan, Heather / Jue, Gregory / Mohr, Karen / Brown, Patty / Watanabe, Drew M / Limpisvasti, Orr

Sports health

2019 Volume 11, Issue 2, Page(s) 149–156

Abstract: ... with both the nontourniquet extremity and the control group ( P < 0.05). Approximately twice the improvement was seen ... torque (3% vs 11%), total work (6% vs 15%), and average power (4% vs 12%) for the BFR group ( P < 0.04 ... compared with the control group ( P < 0.01). Additionally, a significant increase occurred in thigh girth ...

Abstract	Background:: Blood flow restriction (BFR) training involves low-weight exercises performed under vascular occlusion via an inflatable cuff. For patients who cannot tolerate high-load exercises, BFR training reportedly provides the benefits of high-load regimens, with the advantage of less tissue and joint stress. Hypothesis:: Low-load BFR training is safe and efficacious for strengthening muscle groups proximal, distal, and contralateral to tourniquet placement in the lower extremities. Study design:: Randomized controlled trial. Level of evidence:: Level 1. Methods:: This was a randomized controlled trial of healthy participants completing a standardized 6-week course of BFR training. Patients were randomized to BFR training on 1 extremity or to a control group. Patients were excluded for cardiac, pulmonary, or hematologic disease; pregnancy; or previous surgery in the extremity. Data collected at baseline and completion included limb circumferences and strength testing. Results:: The protocol was completed by 26 patients, providing 16 BFR and 10 control patients (mean patient age, 27 years; 62% female). A statistically greater increase in strength was seen proximal and distal to the BFR tourniquet when compared with both the nontourniquet extremity and the control group ( P < 0.05). Approximately twice the improvement was seen in the BFR group compared with controls. Isokinetic testing showed greater increases in knee extension peak torque (3% vs 11%), total work (6% vs 15%), and average power (4% vs 12%) for the BFR group ( P < 0.04). Limb circumference significantly increased in both the thigh (0.8% vs 3.5%) and the leg (0.4% vs 2.8%) compared with the control group ( P < 0.01). Additionally, a significant increase occurred in thigh girth (0.8% vs 2.3%) and knee extension strength (3% vs 8%) in the nontourniquet BFR extremity compared with the control group ( P < 0.05). There were no reported adverse events. Conclusion:: Low-load BFR training led to a greater increase in muscle strength and limb circumference. BFR training had similar strengthening effects on both proximal and distal muscle groups. Gains in the contralateral extremity may corroborate a systemic or crossover effect. Clinical relevance:: BFR training strengthens muscle groups proximal, distal, and contralateral to cuff placement. Patients undergoing therapy for various orthopaedic conditions may benefit from low-load BFR training with the advantage of less tissue stress.
MeSH term(s)	Adult ; Exercise Therapy/methods ; Female ; Humans ; Knee/physiology ; Lower Extremity/anatomy & histology ; Lower Extremity/blood supply ; Male ; Muscle Strength/physiology ; Regional Blood Flow ; Resistance Training/methods ; Torque ; Tourniquets ; Young Adult
Language	English
Publishing date	2019-01-14
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	2508802-6
ISSN	1941-0921 ; 1941-7381
ISSN (online)	1941-0921
ISSN	1941-7381
DOI	10.1177/1941738118821929
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Zs.A 6996: Show issues

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Article ; Online: Tocilizumab is safe and tolerable and reduces C-reactive protein concentrations in the plasma and cerebrospinal fluid of ALS patients.

Milligan, Carol / Atassi, Nazem / Babu, Suma / Barohn, Richard J / Caress, James B / Cudkowicz, Merit E / Evora, Armineuza / Hawkins, Gregory A / Wosiski-Kuhn, Marlena / Macklin, Eric A / Shefner, Jeremy M / Simmons, Zachary / Bowser, Robert P / Ladha, Shafeeq S

Muscle & nerve

2021 Volume 64, Issue 3, Page(s) 309–320

Abstract: ... 0-fold relative change, P < .001). CSF CRP reduction (-1.8-fold relative change, P = .01) was ...

Abstract	Introduction/aims: We tested safety, tolerability, and target engagement of tocilizumab in amyotrophic lateral sclerosis (ALS) patients. Methods: Twenty-two participants, whose peripheral blood mononuclear cell (PBMC) gene expression profile reflected high messenger ribonucleic acid (mRNA) expression of inflammatory markers, were randomized 2:1 to three tocilizumab or placebo treatments (weeks 0, 4, and 8; 8 mg/kg intravenous). Participants were followed every 4 wk in a double-blind fashion for 16 wk and assessed for safety, tolerability, plasma inflammatory markers, and clinical measures. Cerebrospinal fluid (CSF) was collected at baseline and after the third treatment. Participants were genotyped for Asp Results: Baseline characteristics, safety, and tolerability were similar between treatment groups. One serious adverse event was reported in the placebo group; no deaths occurred. Mean plasma C-reactive protein (CRP) level decreased by 88% in the tocilizumab group and increased by 4% in the placebo group (-3.0-fold relative change, P < .001). CSF CRP reduction (-1.8-fold relative change, P = .01) was associated with IL-6R C allele count. No differences in PBMC gene expression or clinical measures were observed between groups. Discussion: Tocilizumab treatment was safe and well tolerated. PBMC gene expression profile was inadequate as a predictive or pharmacodynamic biomarker. Treatment reduced CRP levels in plasma and CSF, with CSF effects potentially dependent on IL-6R Asp
MeSH term(s)	Adolescent ; Adult ; Aged ; Amyotrophic Lateral Sclerosis/blood ; Amyotrophic Lateral Sclerosis/cerebrospinal fluid ; Amyotrophic Lateral Sclerosis/drug therapy ; Anti-Inflammatory Agents/adverse effects ; Anti-Inflammatory Agents/therapeutic use ; Antibodies, Monoclonal, Humanized/adverse effects ; Antibodies, Monoclonal, Humanized/therapeutic use ; Biomarkers/blood ; Biomarkers/cerebrospinal fluid ; C-Reactive Protein/metabolism ; Cytokines/blood ; Cytokines/cerebrospinal fluid ; Cytokines/metabolism ; Double-Blind Method ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Young Adult
Chemical Substances	Anti-Inflammatory Agents ; Antibodies, Monoclonal, Humanized ; Biomarkers ; Cytokines ; C-Reactive Protein (9007-41-4) ; tocilizumab (I031V2H011)
Language	English
Publishing date	2021-06-24
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural
ZDB-ID	438353-9
ISSN	1097-4598 ; 0148-639X
ISSN (online)	1097-4598
ISSN	0148-639X
DOI	10.1002/mus.27339
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Zs.A 1449: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Evolving the surveillance and workup of heart transplant rejection: A real-world analysis of the Molecular Microscope Diagnostic System.

Alam, Amit / Van Zyl, Johanna / Paul Milligan, Gregory / Michelle McKean, Staci / Patel, Raksha / Anne Hall, Shelley

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons

2022 Volume 22, Issue 10, Page(s) 2443–2450

Abstract: ... between EMBx and MMDx (84% agreement, Cohen's kappa, 0.48, p < .001), systematic differences were observed ... McNemar's test, p < .001) where MMDx classified 32 of 37 discordant cases as rejection. MMDx and dd-cfDNA ... demonstrated slight agreement (72% agreement, Cohen's kappa, 0.39, p < .001); however, systematic differences ...

Abstract	The Molecular Microscope Diagnostic System (MMDx) analyzes RNA transcripts of transplanted heart tissue to differentiate among T cell-mediated rejection (TCMR), antibody-mediated rejection (AMR), injury, and healthy tissue. However, little is known about its performance in relation to other modalities in a real-world heart transplant population. We evaluated whether MMDx performs in agreement with other validated modalities. Two hundred and twenty-eight corresponding endomyocardial biopsies (EMBx) and MMDx specimens from 135 adult heart transplant patients were retrospectively reviewed with correlating donor-derived cell-free DNA (dd-cfDNA). Rejection was classified on EMBx in 29 specimens (TCMR ≥ 2R and/or AMR ≥ 1), on MMDx in 56 specimens, and in 74 values with dd-cfDNA ≥0.20%. Despite moderate agreement between EMBx and MMDx (84% agreement, Cohen's kappa, 0.48, p < .001), systematic differences were observed (McNemar's test, p < .001) where MMDx classified 32 of 37 discordant cases as rejection. MMDx and dd-cfDNA demonstrated slight agreement (72% agreement, Cohen's kappa, 0.39, p < .001); however, systematic differences were also apparent where MMDx classified 12 of 50 discordant specimens as rejection when dd-cfDNA was <0.20% (McNemar's test, p < .001). Our findings provide insight on the performance of MMDx relative to other modalities in a heart transplant cohort and have implications on the surveillance and workup of allograft rejection in heart transplantation.
MeSH term(s)	Adult ; Antibodies ; Cell-Free Nucleic Acids/genetics ; Doxorubicin/analogs & derivatives ; Graft Rejection/diagnosis ; Graft Rejection/etiology ; Heart Diseases ; Heart Transplantation/adverse effects ; Humans ; Kidney Transplantation ; Postoperative Complications ; RNA ; Retrospective Studies
Chemical Substances	Antibodies ; Cell-Free Nucleic Acids ; methoxy-morpholinyl-doxorubicin (108852-90-0) ; RNA (63231-63-0) ; Doxorubicin (80168379AG)
Language	English
Publishing date	2022-05-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	2060594-8
ISSN	1600-6143 ; 1600-6135
ISSN (online)	1600-6143
ISSN	1600-6135
DOI	10.1111/ajt.17087
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Zs.A 5542: Show issues

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Article ; Online: Effectiveness and Safety Profile of Remote Pulmonary Artery Hemodynamic Monitoring in a "Real-World" Veterans Affairs Healthcare System.

Milligan, Gregory Paul / Minniefield, Nicole / Raju, Bharath / Patel, Nishi / Michelis, Katherine / Van Zyl, Johanna / Cheeran, Daniel / Alam, Amit

The American journal of cardiology

2022 Volume 184, Page(s) 56–62

Abstract: ... with a 52% (95% confidence interval 30% to 68%, p <0.001) and a 44% (95% confidence interval 24% to 59%, p ...

Abstract	Ambulatory hemodynamic monitoring has demonstrated the ability to reduce heart failure-related hospitalization, regardless of left ventricular ejection fraction; however, real-world data in a Veterans Affairs patient population are limited. The present study retrospectively reviewed 53 patients with New York Heart Association class III heart failure, regardless of left ventricular ejection fraction, implanted with a pulmonary artery pressure sensor (CardioMEMS) at our single Veterans Affairs institution. Heart failure-related hospitalizations were assessed in patients for 6 and 12 months after the implantation of the device and compared with the 6- and 12- month periods before implantation in the same patient cohort. Pulmonary arterial pressures and medication doses were also recorded at baseline, 6- months, and 12- months and procedural safety data were also assessed. Implantation of a remote pulmonary artery pressure sensor was associated with a 52% (95% confidence interval 30% to 68%, p <0.001) and a 44% (95% confidence interval 24% to 59%, p <0.001) reduction in heart failure-related hospitalization at 6 and 12 months after implant, respectively, compared with the 6- and 12-month preimplant periods. Mean pulmonary arterial pressures also demonstrated significant reductions from baseline to 6 and 12 months after implant. A total of 3 procedure-related adverse events were noted. In conclusion, pulmonary artery pressure sensor implantation is relatively safe and associated with significant reductions in heart failure-related hospitalization and decreased mean pulmonary artery pressures in patients within the Veterans Affairs system with New York Heart Association class III symptoms, regardless of ejection fraction.
MeSH term(s)	Humans ; Hemodynamic Monitoring ; Stroke Volume ; Pulmonary Artery ; Blood Pressure Monitoring, Ambulatory ; Heart Failure/diagnosis ; Retrospective Studies ; Veterans ; Ventricular Function, Left ; Delivery of Health Care
Language	English
Publishing date	2022-09-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	80014-4
ISSN	1879-1913 ; 0002-9149
ISSN (online)	1879-1913
ISSN	0002-9149
DOI	10.1016/j.amjcard.2022.08.039
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